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HOLIDAY CVS, L.L.C.
RWI32204 AIDS HEALTHCARE FOUNDATION
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Covered Entity Details
Entity Name
AIDS HEALTHCARE FOUNDATION
Subdivision Name
AHF JACKSONVILLE
Type
Ryan White Part A
340B ID
RWI32204
Entity Address
2 SHIRCLIFF WAY
Suite 900
JACKSONVILLE, FL 32204
Grant Number
H89HA00039
Participating Start Date
7/1/2007
Last Recertification Date
2/20/2025
Pharmacy Details
Pharmacy Name
HOLIDAY CVS, L.L.C.
Pharmacy Address
DBA: CVS/PHARMACY # 03118
1190 DUNN AVE
JACKSONVILLE, FL 32218
Pharmacy Comments
Contract Details
Approval Date
10/10/2022
Contract Begin Date
1/1/2023
Carve-In Effective Date
Contract Comments
Contacts
Covered Entity Signing Official
Rena DeStefano, Director of Pharmacy Finance
(631) 370-2022
Contract Pharmacy Representative
CVS Health
Christian J Reid, 340B Program Director
(401) 374-9782
Signed By Date
10/10/2022
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